FACTORS AFFECTING URINARY ELIMINATION
Growth and development
Psychological, sociocultural, and personal habits
Positioning and Muscle
... [Show More] tone
Food and fluids
Pathological conditions
Medication and surgery
URINARY ELIMINATION ASSESSMENT
Abdominal Assessment: palpate the abdomen for any bladder distention and observe for
overflow.
Urinary Pattern:
Intake and Output: encouraged to drink at least eight, eight-ounce glasses of fluids daily. The
average volume urinated in a 24-hour period is normally 1,200-1,500 mL.
Urine Characteristics: urinary frequency, urgency, incontinence, burning, or nocturia. These
abnormal patterns can indicate a bladder infection or dysfunction.
How the client Eliminates: Every effort should be made to have clients eliminate as normally as
possible.
URINARY INCONTINENCE
Urinary incontinence involves the inability to control the bladder sphincter and is classified by cause.
Here are different types of urinary incontinence and some common interventions.
Stress incontinence= leaking dribbling with sneezing, cough, or laughter. Pelvic floor exercises
(Kegels) to strengthen pelvic muscles
Urge incontinence= after a strong sense of urgency, may be in small/large amounts. Avoid
bladder irritants. Try bladder training/pelvic floor exercises
Overflow incontinence= cannot completely empty the bladder, which leads to leaking. Timed or
double voiding. Catheterization for severe cases
Functional incontinence= bladder function is normal but pt is unable to access the toilet d/t
physical or cognitive condition
Reflex Incontinence= incontinence w/ no sense of urgency. Empty bladder at scheduled times
Transient Incontinence= treatable or reversible incontinence. Treat the cause.
Protecting the skin of an incontinent client is also very important due to the acidity of the urine.
A bladder scan will get an accurate measurement of the post-void residual volume.
URINARY TRACT INFECRTIONS (UTIs)
1
Occur when external bacteria enter the sterile urethra and cause an inflammatory response.
Can also spread bacteria from bladder to kidneys
Classic signs of UTIs
1. Dysuria: pain w/ urination
2. Urinary frequency and/or urgency
3. Incontinence
4. Cloudy urine/odor
5. Flank pain
6. Fever
Client education:
Maintain adequate hydration
Voiding at regular intervals
Allowing enough time to empty the bladder
Voiding after sexual intercourse
CATHETERIZATION
Catheters may be used to:
relieve urinary retention
obtain a sterile urine specimen
measure the amount of residual urine in the bladder
empty the bladder before and during surgery
prepare for certain diagnostic procedures
Types of catheters:
1. Indwelling: Also referred to as a urethral or suprapubic catheter, this is inserted into the
bladder via the urethra or abdomen. It is anchored by a balloon and drains by gravity to a
drainage bag attached to a leg (leg bag) or bed. STERILE TECHNIQUE IS USED
2. External: Also known as a condom catheter, this is placed outside the body on male clients and
has a lower risk than indwelling catheters. In infants and small children, a bag that sticks to the
surrounding perineal area can be used in either gender.
3. Intermittent: A short-term catheter is used to empty the bladder. No anchor is necessary. These
catheters are used to quickly empty the bladder, then discontinued. This is also known as a [Show Less]